Články a aktuality 2012 - 2018

Ovarian cancer is one of the most lethal cancers affecting women, being the 4th most common cause of tumor-related death in women and the most lethal gynecological malignancy. In order to improve outcome, we need sensitive and specific biomarkers for the early detection of the disease, sensitive markers for monitoring therapy and predictive markers for identifying patients likely to benefit from specific therapies. Although over 50 biomarkers have been proposed for ovarian cancer, the 2 most investigated are CA 125 and HE4. Indeed, CA 125 and HE4 have been shown to be the most sensitive biomarkers for the early detection of ovarian cancer. Despite this, neither marker can be recommended for screening for ovarian cancer in asymptomatic women outside the context of a randomised controlled trial. Preoperative levels of CA 125 in combination of transvaginal ultrasound or combined measurement of CA 125 and HE4 (as in the ROMA algorithm) may aid the differentiation of benign and malignant pelvic masses. For differentiating benign from pelvic masses, HE4 has been reported to be more specific than CA 125. Furthermore, HE4 alone or combined measurement of CA 125 and HE4 (as in ROMA) appears to be superior to CA 125 alone, in the differential diagnosis of pelvic masses. Serial levels of CA 125 during chemotherapy for ovarian cancer are useful for assessing response to treatment. However, the value of measuring CA 125 following surgery/initial chemotherapy is unclear. Other serum biomarkers proposed for ovarian cancer include OVA1, OVX1, transthyretin, osteopontin, transferrin, CEA, CA 15-3, CA 19-9 and mesothelin. Currently however, only CA 125 and to a lesser extent, HE4, are in regular clinical use. A tissue-based biomarker recently recommended for clinical use involves BRCA1/2 mutation testing for predicting response to PARP inhibitors such as olaparib.

This prezentation was supported by project Molekulární genetika nádorových a kardiovaskulárních chorob (CZ.1.07/2.3.00/20.0040)